health insurance
Do you feel discriminated against by your insurance company? I recently changed my health insurance carrier due to my employer. The last one would not authorize a cmg. This one approved it and I literally jumped for joy only to find out that my deductible is 10 x when compared to other people, so I have to pay full price for my Dexcom ($1100.00) and each month of sensors ($350.00) will cost full price until my $6000.00 deductible is fulfilled. This, I feel is so unfair. I can't afford to hand over $1500 upfront for a month of cgm. I am feeling very discriminated against. They can't deny me insurance by law, but they can pay less of my costs by increasing my deductibles because I have a preexisting condition my medical needs/costs cost more than the ordinary individual. We all pay the same premiums (my coworkers and I), yet their deductibles are less and they don't need durable medical equipment to live and prevent even more complicated and more expensive treatments down the road. What do you think?
Tags: cmg, dexcom, discrimination, health, insurance
Replies to This Discussion
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Permalink Reply by Ally on -
Wow! Reading some of the comments, and your story, Lisa, frustrates me. I don't think it's fair that a pre-existing condition screws you over. It's not like we volunteered to be diabetics. I understand that it can be an expensive disease, but holy crap. I don't know who your insurance is Lisa, but have you explored 1000% all of your options? I recently found out that my coverage was a whole lot better if things were billed through a different department, than through what they were being billed through. I hope that makes sense.
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Permalink Reply by Kari on -
This is what I'm terrified will happen to me next year. Currently, I'm under contract as a teacher in Wisconsin. Next year I will be a non-contracted teacher in Wisconsin (our district won't renew or write new ones because of all the political uncertainties). We are almost certainly changing insurance companies. I will have no protections to have the same deductibles as other employees. Ugh.
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Permalink Reply by Brock G on -
Yeah, that happens to me every two years when my comapny switched insurance companies. Most times I have no issues, but this year I found my deductible was much higher then everyone elses. I am shopping for a pump and CMG and getting stressed out from the insurance end of it.
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Permalink Reply by Kari on
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Sorry you are having to pay higher deductibles. It sucks.
I hate to lose the insurance I have now. I have copays on dr. visits, but otherwise it's great. Copays on non-D prescriptions are about $5, my insulin costs me $10 (for 3 bottles of Novolog), my test strips (250/month) are free and my pump supplies are free. I have it good now. I don't mind paying higher copays, since I know most people do. But THOUSANDS in deductibles.....I can't handle that with my current salary. I would have to change my entire way of life (which isn't 'superb' now....I walk to work, 'brown bag' it everyday for lunch, live in a tiny 1 bedroom apt w/ my boyfriend)...
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Permalink Reply by Natalie ._c- on -
Free pump supplies is really a bonus. I pay 20% -- and since supplies are so expensive, it amounts to about $150 a month, more or less. And I know what you mean about living frugally -- if a teacher's salary is low, so is their retirement pension -- but at least there IS a pension. Not enough to live on, but every little bit counts.
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Permalink Reply by Kari on
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I was recently told that if I continue to order from Animas I will have to pay 30%. But if I use an approved third party provider they will pay all of it. So of course I'll use a third party provider!
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Permalink Reply by Lisa on -
Who is the third party supplier, Medtronic? Not that it's that bad. I do like it. I just don't like their cgm. I like Dexcom better.
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Permalink Reply by Kari on
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No, because Medtronic is another manufacturer (the competition!), and apparently my insurance won't work with manufacturers (they didn't when I used a Minimed Paradigm pump either). I have to get my Animas supplies through a place called Edgepark Surgical Supply.
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Permalink Reply by Laura S. on
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It sure is all different.
I can get my supplies through Animas (100 percent paid) but I cannot get a new pump direct from anyone who will give me financing or trade in value.
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Permalink Reply by Lisa on
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Edgepark is where I got my Dexcom, but they can't provide me with any supplies for my pump. I have to go to Medtronic for that and their customer service stinks, if you ask me. Because I am forced to have Medicare as my primary, that makes it worse. I had to give back my pump I paid for (Medtronic only gave me half my money back) and now I have to rent my pump each month per Medicare. Plus I have to send them a log of my blood sugars every three months to prove I'm still diabetic! Like I would be trying to get supplies if I weren't. I guess I could be selling them on the black market. lol. Medicare doesn't pay for cgm's so that's why my private is using their huge deductible, even through medicare pays about 99% of my office visits, x-rays, labs, etc.
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I'm confused as to how they could have your deductible set so high and everyone else's lower.
As a small business owner (very small), I know when I pick a plan it would have to go across the board to every employee.
If I had employees who wanted in, they would all be on exactly the same plan with the same features.
Most companies buy a group plan, and as you said, the employees kick in the same amount of money.
I cant see how in the world you would have a higher deductible?
Your DME within the plan might be horrible (mine is, it's fifty percent and no CGMS coverage at all), but if you have a deductible no one else has....well, I dont see how they could do that.
Unless due to the looming health insurance changes, they have changed the plan recently so they can afford to cover employees? Are all new hires receiving the terms you are?
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Permalink Reply by Jeannie Wagner on -
I can't blame politicians because we have had that $6000 deductible for many years. Our premiums usually go up about $80 a month, but this year they went up almost $200 a month. I think part of it is our age. We are both 60 and diabetic. So even though we are healthy and have low HbA1c's in the low 5's we are in that age group where people have expensive medical bills, even though we don't. We have our own company but don't pay for employees health insurance because they would have to pay the same rates as us. We pay them a higher hourly wage to make up for it and since they are younger they can get insurance for less than $100 per month. The only way we would meet our deductible would be to go into the hospital and then the first hour we would probably meet it.
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